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Weinberg/Gill Measure To Guarantee Insurance Coverage For Oral Cancer Drugs Approved In Senate

A view of the Senate Chambers from the 2010-2011 Senate Reorganization.

Measure Would Require that Oral Cancer Drugs Are Covered on Similar Basis to Intravenous Cancer Drugs

TRENTON – A bill sponsored by Senators Loretta Weinberg and Nia H. Gill which would require that all health insurers in New Jersey cover orally-administered cancer medications under similar terms and conditions used in the coverage for intravenous or injected cancer drugs was approved by the Senate yesterday.

“With great advancement in medical research over the past decade, orally-administered cancer drugs, which have fewer side-effects including reduced nausea and hair loss, have become more popular. Compared to intravenous drugs, which must be administered at a hospital, clinic or doctor’s office, orally-administered cancer drugs can be taken from the comfort of a patient’s home,” said Senator Weinberg (D-Bergen), Chairwoman of the Senate Health, Human Services and Senior Citizens Committee. “There’s simply no reason to have two standards of insurance coverage when people suffering from cancer can get the same medicine with more convenience and fewer harsh side effects.”

The bill (S-1834) would require health insurers to provide insurance coverage for prescribed, orally-administered cancer medications on a basis which is no less favorable than the policy or contract provides for injected anticancer medications. Under the bill, insurers would be prohibited from subjecting the coverage of oral cancer medication to any prior authorization stipulations, dollar limits, copayments, deductibles or coinsurance standards that do not apply to intravenously-administered or injected cancer drugs. The bill would also prohibit insurers from imposing new barriers on injected anticancer drugs in order to comply with the provisions of this bill.

“For people suffering from cancer, sometimes the prescribed course of treatment can be just as painful as the disease. Oral-cancer medications can be administered with minimal physician oversight and reduced negative side effects,” said Senator Gill (D-Essex and Passaic), Chairwoman of the Commerce Committee. “Unfortunately under current law, many orally-administered cancer drug options are covered under prescription drug plans with higher co-pays and annual coverage limits rather than the more inclusive medical plans. We therefore must change the law so that the cancer patient and the doctor can determine the best treatment option based on medicine rather than the financial status of the patient.”

The bill passed the full Senate by a vote of 37-2. It now heads to the Assembly for consideration.

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